Then you have a good argument to get the claim paid. For more info see http://www.steveshorr.com/wrong.or.imcopmplet.info..htm
When they passed what? The question is probably, what if the application is denied, because of a medical problem? If that happens try another company. Do you mean if the applicant lied on their application? Then see http://www.steveshorr.com/wrong.or.imcopmplet.info..htm For more info see www.SteveShorr.com/life.htm
Yes. If the medical provider wants to challenge the denial then the medical provider must submit his request for reconsideration within a certain time limit. The bill-er would have to contact the insurance company to find out when the time limit ends and if the denied claim can be re-billed with special documentation.
No, If you are the insured and you have suffered a loss all you do is call your insurer and file a loss notice. If the loss is covered under the terms of your policy then your company will repair your damages. If you are talking about a disagreement with a claim that your company denied due to no coverage then you might seek the advice of an attorney, But just to file a claim no, you should not need an attorney. Remember that if it is your insurance policy then you are the insured. So to sue the company might require that you sue yourself, which is not possible.
Please give me more information, and I'm sure I can help. Facts of loss? Exact reason they denied your claim? They must give you the reason that your claim was denied, or that you were found neglient. You can file with your company then they can arbitrate the claim for a decision, you can contact the dept of insurance for your state. You can file suit (small claims if under the limit), if you secure a judgment against their insured they will have to pay, (barring any appeals of course), but need to know the reason for denial, to be of real help to you.
a non waiver agreement is a bi-lateral agreement between an Insured(policy holder) and the insuror(ins company) alerting both of a POSSIBLE coverage issue. This document is typically executed with the Insured prior to commencing with an investigation into an insurance claim the insured has submitted for coverage. The purpose of the non-waiver is to place the Insured on notice of potential coverage issue(s) that will be sorted out by the ins. co as the investigation proceeds. In a practical sense, it avoids the senario of the insured ASSUMING coverage is afforded for a submitted loss/claim and then subsequently finding out days, weeks or perhaps months later that coverage was denied based upon what was revealed during the investigation. A Resevation of Rights accomplishes similar but is more forceful.
Listen to the explanation. It can be because the insured did not have the specific coverage to pay for your damage. For example, if the other party had collision coverage only on his/her auto policy, it would not pay for your damages because it covers only damage to his/her car. Liability coverage would be needed to pay for your damages. Another reason might be that the other party, especially if insured under a commercial policy, might have a large self-insured retention. This is similar in nature to a deductible, but applies to the liability coverage. The insurer is not obliged to pay until damages exceed the amount of the retention. Yet another reason is that even if the other party did once have liability coverage, it may have been canceled because the personh did not make the required premium payments. The insured is generally required to timely report the collision to his/her insurer so that the insurer can investigate. If there has been no report, or if the insured otherwise fails to cooperate with his/her insurer, coverage may be denied. Finally, the insurer, after investigation, may conclude that its insured did not cause the damage. If so, you will have to decide whether to sue the other party for damages. If the occurrence was one to which the insurance applies, the insurer will generally defend its insured in the suit and pay those damages which the insured is found to be legally liable.
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